Health care was in the news all week long. President Obama pitched his plans for a health care overhaul to the American Medical Association, a politically powerful interest group that has blocked serious attempts at systemic change in the past.* Obama dangled a promise of medical malpractice reform, a first for a Democratic President, but stopped short of endorsing the caps on jury awards the AMA has been angling for.

In Congress, the House and Senate continued to work towards their own broad-based health care reform bills. This week legislators were told their early proposals could cost up to $1.6 trillion(!), which would increase our health spending by more than 50% in one fell swoop.

The issues on the table right now are all the major ones, which is good, and they’re closely linked: legislators want to improve access to health care for those with inadequate or no health insurance; to fund the corresponding increase in health care expenditures, which are certain to be massive; and to make sure we’re getting good value for our money. It’s a terribly complex process, with powerful interest groups such as doctors, hospitals, insurers, and the pharmaceutical industry all vying for a piece of the action. No surprise it didn’t come out perfect the first time.

It seems pretty clear that the interests of patients are somewhat secondary in this process, and things may remain that way.

Meanwhile, legislators are back to the drawing board, to address the funding piece. Let’s hope the momentum for change remains.

audrey young

I'm a general internist from Seattle. My first book was What Patients Taught Me. The latest book is House of Hope and Fear, published in August 2009, and now out in paperback. For more about both books and about physician writers, please visit my website.